Vitamin D does zilch for CVD prevention: meta-analysis

  • Barbarawi M & al.
  • JAMA Cardiol
  • 19 Jun 2019

  • International Clinical Digest
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Takeaway

  • Vitamin D offers no benefit for cardiovascular disease (CVD) prevention, based on results of this meta-analysis of 21 randomized trials and 83,291 participants.
  • Results represent the final nail for D in primary prevention, with an analysis adding in the newest findings from recent trials.  

Why this matters

  • Observational studies had suggested some benefit of D for CVD prevention.
  • The title of the accompanying editorial, “ The Demise of Vitamin D for Cardiovascular Prevention ,” pretty much says it all. 
  • The editorial notes that vitamin D therapy remains indicated for patients with chronic kidney disease and hyperparathyroidism.

Key results

  • For vitamin D vs placebo, risk ratios (95% CIs) were:
    • Major cardiovascular events: 1.00 (0.95-1.06; 6243 patients),
    • Myocardial infarction: 1.00 (0.93-1.08; 2550 patients),
    • Stroke: 1.06 (0.98-1.15; 2354 patients),
    • CVD mortality: 0.98 (0.90-1.07; 2202 patients), and
    • All-cause mortality: 0.97 (0.93-1.02; 6502 patients).
  • No differences seen based on sex, dosage, formulation, calcium administration.

Study design

  • Meta-analysis of 21 randomized controlled trials (4 with explicit CVD outcomes); mean participant age, 65.8 years; 74.4% female.
  • Outcomes: included major adverse cardiac events, stroke, mortality.
  • Funding: None disclosed.

Limitations

  • Most trials did not specify CVD-related primary endpoint.
  • No patient-level data.